Division of Gastroenterology, Department of Medicine, Duke University Medical Center, Durham, NC, USA.
Duke Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA.
Dig Dis Sci. 2021 Sep;66(9):2956-2963. doi: 10.1007/s10620-020-06616-5. Epub 2020 Sep 23.
Patients with chronic hepatitis C and risky/harmful alcohol use experience poor outcomes. Granular data evaluating whether alcohol counseling during hepatitis C treatment impacts longitudinal alcohol consumption are lacking.
To evaluate whether provider-delivered counseling in the context of direct-acting antiviral hepatitis C treatment associates with decreased longitudinal alcohol consumption.
We performed secondary data analysis from the Hep ART study including adults with hepatitis C who underwent provider-delivered counseling during direct-acting antiviral treatment between October 2014 and September 2017. Demographics and disease characteristics were summarized. Alcohol consumption, abstinence, and heavy drinking were evaluated in periods before, during, and after direct-acting antiviral treatment. Multivariate regression analyses were performed to evaluate the association of alcohol consumption with each 12-week time period for all patients and a subsample with cirrhosis.
One hundred twenty-three patients were included; 41 had cirrhosis. Most patients were male (74.0%) and Black (58.5%). Alcohol consumption improved during direct-acting antiviral treatment and was notably sustained (< 12 weeks before treatment 32.5 g/day; during treatment 20.0 g/day; and 12-24 weeks after treatment 23.7 g/day). Multivariable analyses showed significantly improved alcohol consumption metrics during and after antiviral treatment compared to < 12 weeks before treatment (during treatment 13.04 g/day less, p = 0.0001; > 24 weeks after treatment 15.29 g/day less, p = 0.0001). The subsample with cirrhosis showed similar results (during treatment 13.21 g/day less, p = 0.0001; > 24 weeks after treatment 7.69 g/day less, p = 0.0001).
Patients with chronic HCV and risky/harmful alcohol use given provider-delivered alcohol-related counseling during HCV treatment sustain decreased alcohol consumption patterns during and after treatment.
患有慢性丙型肝炎且有风险/有害饮酒行为的患者预后较差。缺乏评估丙型肝炎治疗期间提供的酒精咨询是否会影响纵向酒精消耗的具体数据。
评估在直接作用抗病毒丙型肝炎治疗背景下，医生提供的咨询是否与纵向酒精消耗减少相关。
我们对 HepART 研究进行了二次数据分析，纳入了 2014 年 10 月至 2017 年 9 月期间接受直接作用抗病毒治疗期间接受医生提供的咨询的丙型肝炎患者。总结了人口统计学和疾病特征。在直接作用抗病毒治疗之前、期间和之后的各个时间段评估酒精消耗、戒酒和重度饮酒情况。对所有患者和肝硬化亚组的每个 12 周时间段进行多变量回归分析，以评估酒精消耗与每个时间段的关联。
共纳入 123 例患者，其中 41 例有肝硬化。大多数患者为男性（74.0%）和黑人（58.5%）。在直接作用抗病毒治疗期间，酒精消耗有所改善，且明显持续（治疗前<12 周 32.5 克/天；治疗期间 20.0 克/天；治疗后 12-24 周 23.7 克/天）。多变量分析显示，与治疗前<12 周相比，治疗期间和治疗后酒精消耗的指标显著改善（治疗期间少 13.04 克/天，p=0.0001；治疗后>24 周少 15.29 克/天，p=0.0001）。肝硬化亚组也显示出相似的结果（治疗期间少 13.21 克/天，p=0.0001；治疗后>24 周少 7.69 克/天，p=0.0001）。
接受慢性 HCV 和风险/有害饮酒的患者在 HCV 治疗期间接受医生提供的与酒精相关的咨询，可在治疗期间和治疗后持续减少酒精消耗模式。
